Brianna Hawk and Kayla Martinez wore the awareness bracelets, from the Keep A Breast Foundation, to school on Breast Cancer Awareness Day in defiance of the ban. They were each suspended from school for the infraction, and they filed suit.

The girls challenged the school district in 2010 with the help of the American Civil Liberties Union. The girls testified they merely wanted to raise awareness of breast cancer at their middle school.

District lawyer John Freund described the bracelets as "cause-based marketing energized by sexual double-entendres." He said middle school is "a witch's brew of hormones and curiosity," and said the bracelets' sexual undertone was meant to invite disruption.

The school district appealed after the lower court ruled for the students. The 3rd U.S. Circuit Court of Appeals agreed with the lower court.

In a split opinion, the court rejected the argument that the bracelets were lewd and disruptive. The court found breast cancer awareness among young people to be a relevant social issue, and found the bracelets did not cause disruptions at school.

In a rare move, the entire 3rd Circuit heard the school district's appeal rather than leave it to a three-judge panel. During those arguments, Judge Dolores Sloviter said she did not see the slogan as sexual, and told the crowded courtroom that she had lost a colleague on the court to breast cancer.

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